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利培酮和氟哌啶醇治疗前及治疗期间血清白细胞介素-2、-6和-8水平的变化:与精神分裂症预后的关系

Changes in serum interleukin-2, -6, and -8 levels before and during treatment with risperidone and haloperidol: relationship to outcome in schizophrenia.

作者信息

Zhang Xiang Yang, Zhou Dong Feng, Cao Lian Yuan, Zhang Pei Yan, Wu Gui Ying, Shen Yu Cun

机构信息

Institute of Mental Health, Peking University, Beijing, China.

出版信息

J Clin Psychiatry. 2004 Jul;65(7):940-7. doi: 10.4088/jcp.v65n0710.

Abstract

BACKGROUND

Many studies have indicated that immune cytokines may be involved in the pathophysiology of schizophrenia. Recently, there have been reports that typical and atypical antipsychotic drugs may influence the levels of cytokines or cytokine receptors. The aim of this study was to compare the effect of typical and atypical antipsychotic drugs on serum interleukin-2 (IL-2), interleukin-6 (IL-6), and interleukin-8 (IL-8) and to investigate the relationship between the changes in cytokines and the therapeutic outcome in schizophrenia.

METHOD

From April 1996 to August 1997, seventy-eight inpatients with a diagnosis of chronic schizophrenia (DSM-III-R) were randomly assigned to 12 weeks of treatment with 6 mg/day of risperidone or 20 mg/day of haloperidol. Clinical efficacy was determined using the Positive and Negative Syndrome Scale. Serum IL-2 was assayed by radioimmunometric assay, and serum IL-6 and IL-8 concentrations were measured by quantitative enzyme-linked immunosorbent assay in patients and 30 sex- and age-matched normal subjects.

RESULTS

Both risperidone and haloperidol reduced the elevated serum IL-2 concentrations in schizophrenia, and no significant difference was noted in the reduction of serum IL-2 concentrations between risperidone and haloperidol treatment. Neither risperidone nor haloperidol showed significant influence on the higher serum IL-6 or IL-8 concentrations in schizophrenia. Correlations between serum IL-2 or IL-8 concentrations at baseline and the therapeutic outcome were observed, demonstrating that patients presenting with low concentrations of serum IL-2 or IL-8 at baseline showed greater improvement and patients presenting with higher serum IL-2 or IL-8 concentrations at baseline showed less improvement after treatment.

CONCLUSIONS

Both typical and atypical anti-psychotic drugs may at least partially normalize abnormal immune alterations in schizophrenia. Some immune parameters at baseline may be useful for predicting the neuroleptic response of schizophrenic patients.

摘要

背景

许多研究表明免疫细胞因子可能参与精神分裂症的病理生理学过程。最近,有报道称典型和非典型抗精神病药物可能会影响细胞因子或细胞因子受体的水平。本研究的目的是比较典型和非典型抗精神病药物对血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)的影响,并探讨细胞因子变化与精神分裂症治疗结果之间的关系。

方法

从1996年4月至1997年8月,78例诊断为慢性精神分裂症(DSM-III-R)的住院患者被随机分配接受为期12周的治疗,其中一组每天服用6毫克利培酮,另一组每天服用20毫克氟哌啶醇。使用阳性和阴性症状量表确定临床疗效。通过放射免疫分析法检测血清IL-2,通过定量酶联免疫吸附测定法测量患者和30名年龄和性别匹配的正常受试者的血清IL-6和IL-8浓度。

结果

利培酮和氟哌啶醇均降低了精神分裂症患者升高的血清IL-2浓度,利培酮和氟哌啶醇治疗组在降低血清IL-2浓度方面无显著差异。利培酮和氟哌啶醇对精神分裂症患者较高的血清IL-6或IL-8浓度均无显著影响。观察到基线时血清IL-2或IL-8浓度与治疗结果之间的相关性,表明基线时血清IL-2或IL-8浓度较低的患者治疗后改善更大,而基线时血清IL-2或IL-8浓度较高的患者治疗后改善较小。

结论

典型和非典型抗精神病药物均可至少部分使精神分裂症患者异常的免疫改变恢复正常。一些基线免疫参数可能有助于预测精神分裂症患者的抗精神病药物反应。

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